\ 


Printed  at 

SING  SING  PRISON 
Ossining,  N.  Y. 


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STATE  OF  NEW  YORK-. 

Il 


Report  of  a  Special  Committee 

OF  THE 

State  Commission  of  Prisons 


/ 


Appointed  to  Investigate  the  Matter 
of  Mental  Disease  and  Delinquency 


19  18 


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MENTAL  DISEASE  AND  DELINQUENCY 


Report  of  the  Special  Committee  of  the  State  Commission  of  Prisons 
appointed  to  investigate  the  matter  of  Mental  Disease  and  Delinquency. 


To  the  State  Commission  of  Prisons : 

At  a  meeting  of  the  State  Commission  of  Prisons  held  June  4,  1918, 
the  following  preamble  and  resolution  were  adopted: 

Whereas,  Investigations  in  many  of  the  penal  and  reforma¬ 
tory  institutions  covering  some  years  past  have  thoroughly  estab¬ 
lished  the  fact  that  a  substantial  proportion  of  the  inmates  are 
mentally  subnormal,  and 

Whereas,  The  State  Commission  of  Prisons  is  convinced  that 
examinations  of  mental  conditions  of  the  inmates  of  penal  and 
correctional  institutions,  if  properly  conducted,  will  admit  of  their 
proper  classification  and  treatment,  and 

Whereas,  The  material  received  from  these  examinations  will 
unquestionably  make  the  problems  of  administration  much  easier 
and  more  effective,  in  that  better  results  in  the  teaching  depart¬ 
ment  can  be  secured  by  the  grading  which  can  be  readily  estab¬ 
lished,  and  improved  industrial  conditions  will  result  from  a 
more  efficient  assignment  to  labor,  and 

Whereas,  We  believe  that  the  solving  of  many  difficult  dis¬ 
ciplinary  problems  can  be  more  easily  accomplished  when  the  au¬ 
thorities  are  in  possession  of  a  complete  history  of  the  offender 
and  that  useless  punishment  of  incorrigibles  who  are  mentally 
subnormal  will  be  prevented  where  a  proper  understanding  of  them 
is  had,  and 

Whereas,  The  detection  of  insanity,  the  recognition  of  various 
less  pronounced  disorders  of  the  mind,  the  proper  diagnosis  of 
the  epileptic  and  the  recognition  of  his  periodical  irresponsibility, 
and  the  segregation  of  the  defective  delinquent  can  all  be  accom¬ 
plished  by  proper  study,  and 

Whereas,  The  study  of  mental  conditions  can  also  be  of  great 
benefit  in  reducing  anti-social  conduct  and  defective  reasoning 
which  have  brought  the  prisoner  into  conflict  with  the  law,  in  ad¬ 
dition  to  which  the  history  thus  obtained  will  make  a  permanent 
record  of  great  value  in  assisting  the  parole  authorities  in  better 
determining  the  matter  of  release,  and  would  give  parole  officers 
a  better  understanding  of  the  persons  whom  they  supervise  to 
the  end  that  there  may  be  an  intelligent  treatment  of  each  un¬ 
fortunate,  which  would  act  as  a  stimulus  to  those  deserving  and 
a  protection  for  the  defective  and  the  weakling,  it  is 

Resolved,  That  an  investigation  be  made  of  the  whole  subject 
by  a  committee  of  this  Commission,  the  committee  to  submit  a 
report  thereon  with  such  recommendations  as  may  be  determined 
upon. 


5 


6  ■'Xm 


Pursuant  to  the  foregoing,  a  committee  was  appointed  consisting  of 
Frank  E.  Wade,  John  S.  Kennedy,  Sarah  L.  Davenport,  Allan  I.  Hollo¬ 
way  and  George  W.  Davids.  Your  committee,  assisted  by  Dr.  V.  V. 
Anderson,  Medical  Director  of  the  Municipal  Court  of  Boston,  Mass.,  a 
well  recognized  expert  in  psychiatry,  made  a  state-wide  investigation,  as 
directed,  into  conditions  in  the  penal  and  correctional  institutions,  and 
into  the  clinical  work  connected  with  the  courts,  taking  the  testimony 
of  judges,  medical  experts,  psychiatrists  and  others,  and  collecting  avail¬ 
able  data  and  statistics  of  the  mental  examinations  of  prisoners  and 
delinquents  in  this  and  other  states.  Based^  upon  such  testimony,  data 
and  statistics,  your  committee  submits  the  following  report  and  rec¬ 
ommendations  : 

SUMMARY 

An  enormous  financial  burden  is  carried  by  every  state  of  the  Union 
in  its  fight  against  crime,  one  of  the  largest  items  in  the  public  budgets 
being  for  this  purpose. 

The  most  depressing  part  of  the  whole  situation  is  that  New  York 
State,  with  all  its  vast  expenditure  of  money  to  detect,  try,  convict  and 
punish  the  criminal,  is  not  repressing  crime  because  sixty  per  cent,  of 
the  population  of  the  various  penal  and  correctional  institutions  of  the 
State  have  served  previous  commitments.  Of  the  2,279  felons  received 
iiito  the  State  prisons  during  the  year  1917,  87  per  cent,  were  repeaters, 
having  served  previous  commitments.  With  each  new  trial  of  this 
particular  group  of  repeaters,  the  State  of  New  York  spends  approx¬ 
imately  two  million  dollars. 

In  the  recidivist  (the  chronic  repeater)  is  found  the  crux  of  the 
whole  criminal  problem.  His  existence  to  such  a  large  extent  among  the 
inmates  of  prisons  is  of  itself  proof  of  society’s  failure  to  repress  crime 
or  to  reform  the  criminal. 

Studies  show  that  the  most  important  single  factor  found  associated 
with  chronic  criminalism  is  the  abnormal  mental  condition  of  the  crim¬ 
inal  himself.  Well  authenticated  facts  are  at  hand  to  indicate  that  at 
least  50  per  cent,  of  the  inmates  of  prisons  and  reformatories  in  New 
York  State  exhibit  mental  abnormalities,  and  are  in  need  of  much  more 
specialized  treatment  than  is  afforded  by  the  ordinary  routine  methods 
employed  in  the  average  penal  institutions;  that  from  27  to  30  per  cent, 
of  such  inmates  are  feeble-minded  and  only  possess  the  intelligence  of  the 
average  American  child  of  twelve  years  or  under. 

In  the  light  of  such  facts  it  is  futile  to  simply  go  on  blindly  admin¬ 
istering  the  law,  instead  of  endeavoring  to  solve  the  problem  these  in¬ 
dividuals  present. 

Those  who  have  given  much  thought  to  the  subject  feel  that  the 
establishment  of  clearing  houses  with  medical  clinics,  through  which 
will  pass  those  sentenced  to  the  various  penal  and  correctional  institu¬ 
tions  of  the  State,  after  prolonged  study  and  effort  at  reconstruction,  to 
then  be  distributed  to  the  various  penal  institutions  in  the  light  of  the 
needs  of  each  case,  is  the  best  way  of  handling  the  problem. 

Such  clearing  houses,  in  enabling  the  prisons  to  establish  an  actual 
physical  segregation  of  certain  types,  will  in  a  great  measure  solve  the 
disciplinary  problems  of  the  prisons.  By  establishing  a  proper  classi¬ 
fication  these  clinics  will  also  enable  the  prison  management  to  better 
utilize  for  the  reconstruction  of  the  prisoner  those  agencies  already 
existing  in  prisons ;  and  will  secure  a  more  intelligent  treatment  of  each 
individual  prisoner,  making  it  possible  for  the  administration  to  return 
him  to  society  better  fitted  to  take  his  place  as  a  useful  member  than 
he  was  the  day  he  entered  prison. 

Furthermore,  such  clinics  should  be  of  very  great  value  to  the  parole 
authorities  in  intelligent  after-care  work  with  criminals. 


As  “an  ounce  of  prevention  is  worth  a  pound  of  cure,”  it  is  much 
more  profitable  for  society  to  undertake  measures  to  prevent  criminality, 
prostitution,  insanity  and  the  like,  than  it  is  to  endeavor  to  cure  it  after 
it  has  already  developed,  or  to  provide  ultimate  custodial  care  for  those 
in  whom  cure  is  impossible. 

The  establishment  of  medical  clinics  in  courts  will  do  much  towards 
solving  the  serious  problems  mentioned,  before  they  have  developed  to 
such  a  degree  as  are  found  in  prisons,  and  when  their  condition  may  in 
a  great  measure  be  preventable. 

But  even  more  important  in  the  prevention  of  delinquency  than  any¬ 
thing  else  that  has  been  said,  is  the  establishment  of  clinics  in  the  com¬ 
munity  that  will  discover  the  abnormal  child  who  has  the  potentialities 
for  a  criminal  career  even  before  he  has  developed  delinquent  tendencies. 

INTRODUCTION 

The  price  paid  by  society  for  its  neglect  of  the  criminal  has  never 
been  adequately  estimated.  Neither  in  dollars  and  cents  nor  in  sorrow 
and  cost  of  wasted  and  frequently  vicious  lives  has  half  the  story  ever 
been  told. 

An  enormous  financial  burden  is  carried  by  every  state  of  the  Union 
in  its  fight  against  crime.  State  and  city  budgets  give  startling  evidence 
of  the  vast  expense  which  criminality  is  to  society,  this  being  understood 
to  be  the  largest  single  item  in  the  public  budget.  To  illustrate : 

The  cost  of  the  detention,  indictment,  trial  or  other  disposition  of  the 
average  felon  is  conservatively  estimated  at  $1,000.  The  2,279  felons 
received  into  the  State  prisons  during  the  year  1917,  cost  the  State  ap¬ 
proximately  two  milion  two  hundred  seventy-nine  thousand  dollars.  Of 
these  individuals  87  per  cent,  had  served  previous  terms  and  by  their 
release  into  the  community  and  return  to  criminal  habits  the  State  spent 
approximately  two  million  dollars  to  again  dispose  of  them  and  continues 
to  spend  such  each  time  it  undertakes  to  convict  this  particular  group  of 
repeaters.  Nothing  can  be  accomplished  in  the  way  of  permanent  good 
for  all  this  expenditure,  if  the  criminal  has  not  been  deterred  from  re¬ 
peating  his  criminal  acts. 

New  York  State  in  1917  received  into  its  penal  and  correctional  in¬ 
stitutions  133,047  prisoners,  60  per  cent,  of  whom  had  served  previous 
commitments. 

Massachusetts  in  a  given  year  received  into  its  institutions  25,820 
prisoners,  57.4  per  cent,  of  whom  were  repeaters;  the  total  number  of 
previous  commitments  being  92,443,  averaging  six  sentences  for  each 
recidivist. 

Justice  Rhodes  of  England  wrote  in  the  British  Medical  Journal,  ask¬ 
ing  what  could  it  all  mean  that  of  180,000  convictions  in  a  given  year, 
more  than  10,000  had  been  convicted  upwards  of  twenty  times  before. 

Wherever  our  investigations  have  led  us,  the  startling  and  depressing 
facts  of  recidivism  stand  out  as  a  proof  of  the  complete  breaking  down 
of  the  social  security  furnished  by  the  State,  in  that  it  has  failed  to  re¬ 
press  crime  through  the  rehabilitation  and  readjustment  of  the  criminal. 

A  most  hopeful  part  of  the  whole  situation,  however,  is  to  be  found 
in  a  widespread  interest  in  the  entire  subject,  and  the  existence  of  power¬ 
ful  forces  bearing  in  from  all  sides,  tending  to  greater  enlightenment 
upon  the  problems  of  crime.  Whether  these  forces  come  from-  law  or 
medicine,  or  psychology,  or  social  or  public  agencies,  they  have  all  contri¬ 
buted  to  a  better  understanding  of  the  criminal  and  the  problem  he 
presents. 

Facts  of  unquestioned  value  are  already  at  hand  which  go  far 
toward  explaining  much  of  past  failures  in  readjusting  the  criminal.  In 
New  York  State,  reports  coming  from  the  State  Reformatory  at  Elmira, 


the  State  Reformatory  for  Women  at  Bedford  Hills,  and  Auburn  and  Sing 
Sing  Prisons,  speak  in  no  uncertain  terms  of  conditions  found  with  such 
a  high  degree  of  frequency  among  prisoners,  particularly  among  recid¬ 
ivists,  as  to  make  clear  a  definite  relationship  between  delinquency  and 
mental  disease  and  defect. 

FINDINGS  AT  SING  SING  PRISON 

Dr.  Bernard  Glueck,  in  the  first  annual  report  of  the  Phychiatric  Clinic 
in  collaboration  with  Sing  Sing  Prison,  states  that  “of  608  adult  prisoners 
studied  by  psychiatric  methods  out  of  an  uninterupted  series  of  683  cases 
admitted  to  Sing  Sing  prison  within  a  period  of  nine  months,  66.8  per 
cent,  were  not  merely  prisoners  but  individuals  who  had  shown  throughout 
life  a  tendency  to  behave  in  a  manner  at  variance  with  the  behavior  of 
the  average  normal  person,  and  this  deviation  from  normal  behavior  had 
repeatedly  manifested  itself  in  a  criminal  act.”  Further,  “Of  the  same 
series  of  608  cases,  59  per  cent,  were  classifiable  in  terms  of  deviation  from 
average  normal  mental  health.  Of  the  same  series  of  cases  28.1  per  cent, 
possessed  a  degree  of  intelligence  equivalent  to  that  of  the  average  Amer¬ 
ican  child  of  twelve  years  or  under.” 

FINDINGS  IN  OTHER  INSTITUTIONS  AND  COURTS 

Such  findings  confirm  similar  reports  coming  from  prisons,  re¬ 
formatories  and  courts  throughout  the  country  as  indicated  in  the  tables 
which  follow: 


8 


TABLE  No.  1 

Showing  Percentage  of  Inmates  of  Prisons  Exhibiting  Some  Nervous  or  Mental  Abnormality 


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9 


The  foregoing  figures  indicating  percentages  of  inmates  suffering 
from  abnormal  mental  conditions,  show  not  only  the  number  of  persons 
with  intellectual  defect  but  include  insanity,  epilepsy,  psychopathic  per¬ 
sonality,  drug  deterioration,  alcoholic  deterioration  and  other  abnormal 
nervous  and  mental  conditions,  which  seriously  handicap  the  individual 
in  his  ability  to  adjust  himself  to  the  conditions  of  normal  living.  All  of 
these  mental  conditions  are  matters  most  important  in  considering  any 
real  constructive  attempt  at  rehabilitating  the  criminal. 

One  of  the  most  important,  if  not  the  most  important  group  of  which 
society  needs  to  take  cognizance,  is  the  feeble-minded.  They  furnish  a 
substantial  nucleus  to  that  most  expensive  body  of  individuals  who  clog 
the  machinery  of  justice,  who  spend  their  lives  in  and  out  of  penal  insti¬ 
tutions  and  furnish  data  for  the  astonishing  facts  of  recidivism — facts 
which  are  serving  to  awaken  our  social  conscience  to  the  need  of  more 
adequate  treatment  under  the  law  for  repeated  offenders.  It  is  of  this 
group  that  Dr.  Walter  Fernald  has  so  well  said :  “Feeble-mindedness 
is  the  mother  of  crime,  pauperism  and  degeneracy.  It  is  certain  that  the 
feeble-minded  and  their  progeny  constitute  one  of  the  great  social  and 
economic  burdens  of  modern  times.” 

The  following  tables  are  most  significant,  showing  the  percentage  of 
inmates  of  prisons,  reformatories  and  other  correctional  institutions,  that 
are  feeble-minded : 


<  • 

V 


10 


Showing  the  Percentage  of  Inmates  of  State  Prisons  Found  Feeble-Minded 


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11 


TABLE  No.  V 

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12 


From  the  foregoing  tables  31.4  per  cent,  of  inmates  of  reformatories, 
training  schools,  workhouses  and  penitentiaries  are  found  to  be  feeble¬ 
minded. 

It  is  clear  from  Tables  I  and  II  that  within  the  prisons,  reformatories, 
penitentiaries  and  workhouses  throughout  the  country  is  found  a  large 
group  of  prisoners  who  exhibit  nervous  and  mental  abnormalities,  who 
are  mentally  crippled  or  mentally  ill.  Fifty  per  cent,  of  the  inmates  of 
these  institutions  require  much  more  specialized  and  much  more  indivi¬ 
dualized  treatment  than  is  afforded  by  the  ordinary  routine  methods  em¬ 
ployed  in  the  average  penal  institution.  •  This  is  not  a  sentimental  con¬ 
sideration  but  a  practical  matter  of  social  security.  Laying  aside  the 
humane  element  involved,  the  paramount  interests  of  society  are  jeopar¬ 
dized  if  we  ignore  the  well  known  facts  of  individual  differences. 

*  In  Tables  III,  IV,  V  and  VI  this  point  is  illustrated.  The  feeble¬ 
minded  delinquents,  found,  as  the  foregoing  tables  will  show,  are  from 
27  to  29  per  cent,  of  the  inmates  of  penal  and  correctional  institutions 
throughout  the  country.  Just  what  sort  of  a  problem  the  seriously  delin¬ 
quent  feeble-minded  person  may  present  is  seen  from  the  following  study 
undertaken  in  connection  with  the  Municipal  Court  of  Boston : 

The  careers  of  100  feeble-minded  delinquents  were  intensively  studied ; 
the  case  histories  were  taken  from  the  court  files  alphabetically,  no  other 
selection  being  required  than  that  each  individual  should  have  been 
diagnosed  feeble-minded.  The  100  persons  in  this  particular  group  were 
arrested  1,825  times ;  record  cards  dating  further  back  than  five  year* 
were  not  gone  into  though  many  had  such  old  court  records. 

The  futility  of  employing  for  this  group  measures  intended  for  those 
capable  of  profiting  by  experience  is  shown  from  the  following  facts  : 

These  delinquents  in  court  were  discharged  after  short  periods  of  de¬ 
tention  or  judicial  reprimand  a  great  many  times  but  they  returned  with 
unfailing  certainty  to  be  handled  over  again.  They  were  placed  on  proba¬ 
tion  432  times,  but  had  to  be  placed  on  inside  probation,  that  is,  within 
institutions  non-penal  in  character,  118  times.  Of  the  remaining  proba¬ 
tionary  periods  they  had  to  be  surrendered  to  the  court  220  times,  making 
in  all  not  quite  one  successful  probationary  period  apiece  for  each  of  .these 
100  individuals.  The  chances  were  better  than  four  to  one  against  any  one 
©f  these  individuals  conducting  himself  normally  for  a  six  months’  proba¬ 
tionary  period. 

The  court,  in  addition  to  probation  for  these  individuals,  tried  penai 
treatment.  They  were  sentenced  735  times,  their  sentences  aggregating  in 
fixed  time  106  years  imprisonment,  exclusive  of  250  indeterminate  sentences 
to  the  reformatories.  But  this  did  not  in  any  way  suffice  to  change  the 
course  of  their  careers. 

Finally  as  an  explanation  of  all  this  maladjustment,  examination  dis¬ 
closed  that  each  one  of  these  100  persons  possessed  a  degree  of  intelligence 
equivalent  to  that  of  the  average  American  child  of  12  years  or  under. 
About  75  per  cent,  had  the  mental  level  of  children  under  10  years.  In¬ 
vestigation  into  the  past  histories  disclosed  the  astounding  fact  that  75 
per  cent,  had  never  been  legitimately  self-supporting.  Worst  of  all,  so  far 
as  society’s  responsibility  is  concerned,  73  per  cent,  of  these  persons,  though 
having  ample  opportunities  for  common  school  education,  beginning  school 
at  the  usual  age  and  leaving  at  the  age  of  14,  15  and  16  years,  were  never 
able  to  get  beyond  the  fifth  grade  in  school. 

How  much  more  profitable  would  it  have  been  to  have  recognized  at 
this  time  the  condition  from  which  these  persons  were  suffering  when  a 
chance  really  existed  in  each  and  every  one  of  these  cases  for  some  ad¬ 
vance  along  the  lines  of  proper  habit  training,  and  to  have  saved  all  of 
this  economic  waste,  protecting  society  as  well  as  these  individuals  them- 
aelves  from  their  weaknesses  and  making  them  useful  members  of  the 
community,  or  placing  them  in  a  limited  environment  suited  to  their  special 
needs. 


13 


RELATION  BETWEEN  MENTAL  DEFECT  AND  DELINQUENCY 

So  far  in  this  report  we  have  endeavored  to  emphasize  two  things : 

First:  That  the  recidivist  is  the  real  problem  in  the  prevention  of 
achieve m  hlm  WG  haVe  failed  t0  accomPlish  that  which  we  set  out  to 

Second :  That  an  important  and  probably  the  most  important  under- 
ymg  causitive  factor  in  this  failure  to  profit  by  such  experience  is  the* 
defective  mentality  by  which  he  is  so  commonly  handicapped.  In  this 
connection  studies  made  by  Dr.  y.  V.  Anderson  of  a  group  of  100  immoral 
women  and  a  group  of  100  drunken  women  showed  that  among  the  im- 
woral  women  39  per  cent,  of  first  offenders,  47  per  cent,  of  second  offenders 
and  84  per  cent,  of  recidivists  were  suffering  from  some  form  of  mental 
and  nervous  handicaps ;  that  among  drunken  women  35.4  per  cent,  of  first 
offenders  and  82.2  pep  cent,  of  recidivists  exhibited  some  nervous  or  mental 
abnormality.  The  relation  between  the  mental  condition  of  these  persons 
and  the  frequency  of  their  offense  is  obvious. 


SITUATION  IN  NEW  YORK  STATE 
TABLE  No.  VII 

Showing  Percentage  of  Inmates  of  Certain  New  York  Penal  and  Re¬ 
formatory  Institutions  Exhibiting  N ervous  and  Mental  Abnormalities : 


INSTITUTION  AUTHORITY 

Sing  Sing  Prison - Dr.  Bernard  Glueck _ 

Auburn  Prison - Dr.  Frank  L.  Heaeox___ 

Clinton  Prison - Dr.  V.  V.  Anderson _ 

Auburn  State  Prison 

(for  women) _ _ Ma'ble  Fernald  Ph.  D _ 

Westchester  County 

Penitentiary - Dr.  Bernard  Glueck _ 

New  York  State  Dr.  Frank  L.  Christian 

Reformatory  - and  Dr.  John  R.  Harding 

New  York  State  Re¬ 
formatory  for  W omen — Mable  Fernald  Ph.  D._^___ 


Percentage  exhibiting, 
nervous  and  mental 
abnormalities 

59 
61.7 

60 

25  Feeble-minded^ 

57 

58 

31.9  Feeble-minded: 


The  existence  of  mental  disease  and  deterioration,  intellectual  defect, 
psychopathic  personality,  epilepsy  and  the  like,  in  a  fairly  large  proportion 
of  the  inmates  of  these  institutions  makes  clear  and  obvious  how  futile1 
it  is  to  merely  go  on  blindly  administering  the  law  instead  of  endeavoring 
to  solve  the  problems  these  individuals  present. 

A  similar  situation  in  treating  disease  would  consist  in  sending  all1 
sick  persons  to  hospitals  to  be  given  the  same  treatment,  fixing  in  advance* 
the  length  of  time  they  were  to  remain  there  and  then  sending  them  out 
without  any  reference  to  whether  they  were  well  or  not. 

Are  we  not  following  similar  lines  in  locking  up  criminals  and  then 
turning  them  out,  and  then  locking  them  up  and  turning  them  out  again, 
without  any  reference  to  whether  our  purpose  in  locking  them  up  had  been 
attained;  or  whether  they  were  any  better  fitted  to  assume  their  normal 
relation  to  society  on  the  day  they  left  prison  than  they  were  the  day  they 
entered  it? 

Even  where  scientific  studies  and  classifications  have  been  undertaken, 
if  these  have  not  been  made  the  basis  for  treatment,  nothing  in  the  way 
of  benefit  to  the  individual  or  security  to  society  can  be  said  to  have  been 
accomplished  by  such  investigations.  The  mere  knowledge  of  the  existence- 
of  these  conditions,  the  mere  labeling  of  a  certain  number  of  prisoners  as 
intellectually  defective  or  mentally  diseased  or  deteriorated,  or  psycho¬ 
pathic,  is  not  enough.  Such  knowledge  should  be  made  the  basis  for  treat¬ 
ment.  Constructive  efforts  should  be  made  to  rehabilitate  these  persons  in 


14 


the  light  of  the  needs  of  each  individual  prisoner ;  not  only  of  his  disabil¬ 
ities,  but  of  his  capabilities  and  his  adaptabilities. 

The  machinery  of  the  penal  institutions  should  be  so  organized  as  to 
enable  it  to  carry  into  effect  such  recommendations  as  would  be  suggested. 

But  as  indicated  from  the  foregoing  tables,  such  a  heterogeneous  group 
as  is  to  be  found  in  all  penal  institutions,  composed  as  it  is  of  types  re¬ 
quiring  entirely  different  lines  of  treatment,  would  preclude  the  possibility 
of  carrying  out  such  a  program  in  every  one  of  the  units  of  a  penal  system 
in  a  great  State  like  New  York,  so  that  those  who  have  given  thoughtful 
consideration  to  the  problem  feel  that  the  situation  could  be  handled  best 
by  establishing  clearing  houses  with  medical  clinics,  through  which  would 
pass  those  prisoners  sentenced  to  prison  and  reformatory  institutions. 

CLEARING  HOUSE  AT  SING  SING 

Every  sentenced  male  felon  first  should  be  admitted  to  the  clearing 

house  now  being  provided  at  Sing  Sing  Prison.  Here  he  should  be  kept 
under  observation  for  a  period  of  three  or  four  months,  studied  physically 
and  mentally,  given  the  very  best  in  the  way  of  modern  medical  treatment, 
placed  under  intensive  vocational  study  and  training  for  such  a  period  of 
time  as  will  be  necessary  to  enable  the  administration  to  define  clearly  the 
problem  which  he  presents.  Soon  after  his  admission  he  should  be  presented 
at  the  medical  clinic  for  a  rigid  and  thoroughgoing  physical  and  mental 
examination.  The  most  approved  clinical  and  laboratory  facilities  known  to 
modern  medicine  will  be  used  in  these  examinations.  The  aim  will  be  not 
only  the  physical  rehabilitation  of  the  prisoner  and  the  delineation  of  those 
underlying  caustive  factors  responsible  for  his  delinquent  career,  but  also 
to  outline  the  abilities  of  each  prisoner  in  order  to  determine  whatever 
qualities  he  may  possess,  the  cultivation  of  which  might  enable  the  penal 
administration  to  restore  him  to  his  normal  relation  to  society  as  promptly 
and  as  permanently  as  possible. 

Undoubtedly  many  criminal  careers  are  due  less  to  inherent  biological 
defects  in  makeup  than  to  the  repeated  exposure  throughout  life  to  un¬ 
favorable  environmental  and  developmental  conditions,  forming  in  this 
way,  many  of  the  character  traits  and  personality  difficulties  so  commonly 
responsible  for  delinquent  behavior. 

The  most  important  phase  therefore  of  the  examination  at  the  clinics 
would  be  a  study  of  the  personality  and  life  history  of  the  individual. 
While  psychological  tests  must  necessarily  be  given  and  a  cross  section 
view  wiH  be  most  helpful,  nevertheless  the  greatest  emphasis  should  be 
placed  on  the  careers  of  these  individuals  as  seen  in  the  light  of  modern 
psychiatric  knowledge  of  behavior. 

It  is  no  doubt  needless  to  add  that  inasmuch  as  the  very  nature  and 
purpose  of  this  clearing  house  is  essentially  medical,  that  all  its  clinical 
activities  should  be  under  medical  direction.  Further,  it  may  be  well  to 
emphasize  that  no  one  phase  of  the  work  such  as  sociological,  phycholog- 
ical,  psychiatric  and  physical  should  constitute  an  independent  unit,  if 
anything  like  a  well  rounded  study  and  an  intelligent  and  understanding 
treatment  of  each  individual  is  aimed  at.  Only  by  making  each  one  of 
these  various  aspects  a  co-ordinate  part  of  a  comprehensive  scheme  in  the 
study  and  treatment  of  each  and  every  individual  prisoner,  can  successful 
results  be  obtained. 

As  stated  before,  the  average  length  of  sojourn  at  the  reception  prison 
will  be  three  or  four  months ;  some  will  not  require  so  long  a  period,  while 
in  other  cases  a  clear  definition  of  the  problem  they  present  will  necessitate 
a  much  longer  period  than  three  or  four  months.  It  will  then  be  possible 
to  supply  to  other  prisons  “a  stream  of  healthy,  sane,  able-bodied  pris¬ 
oners”  who  have  received  treatment  for  physical  defects  and  disease,  whose 
mental  condition  has  greatly  improved  and  who  because  of  prolonged  and 
intensive  vocational  study  and  training,  will  be  able  to  acquire  in  other 
prisons  skill  in  that  trade  or  occupation  best  suited  to  their  abilities.  Those 
discharged  from  the  clearing  house  should  be  distributed  to  the  bther  pris¬ 
ons  in  the  following  manner : 


15 


First:  All  cases  of  tuberculosis  should  be  transferred  to  the  tuber¬ 
culosis  hospital  at  Clinton  Prison. 

Second :  Those  sentenced  to  the  reformatory  at  Elmira  will  be  trans¬ 
ferred  to  that  institution.  This  in  no  way  would  interfere  with  the  power 
of  the  court  to  commit  to  Elmira,  as-  only  the  insane  and  those  of  the 
defective  delinquent  group,  requiring  very  special  care  and  treatment  would 
be  transferred  elsewhere. 

Third :  The  younger  and  more  normal  male  felons  receiving  state 
prison  sentences  should,  be  transferred,  as  Dr.  Glueck  has  said,  “after  hav¬ 
ing  been  well  started  in  acquiring  the  trade  for  which  they  are  best  suited, 
as  determined  by  scientific  inquiry  into  their  capabilities,”  to  either  one  of 
the  two  industrial  prisons  of  the  State,  Clinton  or  Auburn. 

Fourth :  The  older  normal  prisoners  and  those  found  incapable  of 
learning  a  trade  should  be  transferred  to  the  agricultural  prisons,  Great 
Meadow  and  Wingdale,  where  they  can  make  themselves  most  useful  to 
the  State  in  some  form  of  agricultural  occupations. 

Fifth :  The  insane  who  require  treatment  of  a  more  or  less  permanent 
nature  in  hospitals  for  the  insane,  should  be  transferred  to  the  Danne- 
mora  State  Hospital  for  the  Criminal  Insane.  The  more  recoverable  types 
should  remain  at  the  reception  prison  under  proper  treatment  in  a  spec¬ 
ially  constructed  pavilion. 

Sixth:  There  remains  a  very  large  group  known  as  the  defective 
delinquent  group.  The  term  “defective  delinquent”  is  used  here  in  a  sense 
similar  to  that  in  which  the  term  “insane”  is  used,  being  more  of  a  legal 
than  a  strictly  medical  classification.  In  this  group  are  included  the  in¬ 
tellectually  defective  delinquent,  the  psychopathic  delinquents,  the  epileptic 
delinquents  and  the  like.  Those  individuals  belonging  to  this  group,  who 
after  prolonged  and  careful  study  and  training  are  found  incapable  of 
reconstruction  to  a  degree  Which  would  justify  their  release  into  the 
general  community,  should  be  committed  to  an  institution  specially  suited 
to  their  particular  needs,  an  institution  for  defective  delinquents. 

As  the  following  table  indicates,  about  15  to  20  per  cent,  of  prison 
and  reformatory  inmates  may  well  be  segregated  into  such  an  institution : 

TABLE  No.  VIII 

Showing  Percentage  of  Inmates  in  Certain  Prisons  and  Reform¬ 
atories  Regarded  as  Segregate 


INSTITUTION 


AUTHORITY 


Percentage  regarded 
as  segregable 


Auburn  Prison  ( N. Y . )  _ 
Sing  Sing  Prison  (N.Y.) 
New  York  State  Reform¬ 
atory  (Elmira 
San  Quentin  Prison 

(California)  - 

Massachusetts  Reform- 


_ Pr.  Frank  L.  Heacox - 

_ Dr.  Bernard  Glueck - 

Drs.  Christian  &  Harding 
Report  of  San  Quentin 
Prison  _ 

Dr.  Guy  Fernald - 


atory  for  Men - 

assachusetts  Reform¬ 
atory  for  Women _ Dr.  Edith  Spaulding 


17.9 

15  to  25 

17 

17.9 

15.5 

24.8 


The  more  adjustable  members  of  this  “defective  delinquent”  group 
who  show  capacity  for  reconstruction  to  a  degree  that  would  justify 
their  later  release  into  the  community  under  close  and  intensive  super¬ 
vision  should  be  retained  at  the  reception  prison  for  prolonged  training 
as  a  special  group  and  later  transferred  to  the  industrial  and  agricultural 
prisons  for  further  training.  The  intellectually  defective  members  of  this 
group  not  regarded  committable  to  the  institution  for  defective  delinquents 


* 


16 


-who  may  have  little  difficulties  of  personality,  may  furnish  little  trouble, 
aud  may  well  be  made  self  supporting  and  later  restored  through  intelli¬ 
gent  parole  to  the  community.  The  psychopathic  members  of  the  defec¬ 
tive  delinquent  group,  the  neurotic,  unstable,  emotional,  temperamental 
individuals  suffering  from  serious  difficulties  of  personality,  furnish  a 
problem  far  less  easily  solved.  Those  who  do  not  break  down  completely 
under  confinement  and  require  treatment  as  insane,  those  who  do  not 
have  to  be  committed  to  the  institution  for  the  defective  delinquents, 
may  be  given  the  advantages  afforded  from  prolonged  training  and  may 
well,  through  the  education  of  their  inhibitions,  learn  to  control  their  im¬ 
pulsive  tendencies  and  emotional  outbreaks  to  such  a  degree  as  to  enable 
them  later  to  be  incorporated  into  the  community,  achieving  more  or  less 
enduring  adaptation  to  their  industrial  environment  and  protected  from 
the  stresses  and  temptations  to  relapse  by  adequate  social  supervision. 

It  would  be  like  elaborating  the  obvious  to  call  attention  to  the  close 
relationship  such  a  program  bears  to  a  real  indeterminate  sentence. 

It  is  generally  accepted  that  but  for  the  defective  delinquent  group  the 
punishment  problem  would  almost  disappear  in  prisons ;  that  these  indi¬ 
viduals  are  the  source  of  all  disciplinary  measures  required. 

It  is  quite  evident  then  that  proper  classification  would  not  only  be 
of  immense  value  in  this  direction,  but,  what  is  of  the  greatest  impor¬ 
tance  to  the  prison  management,  it  would  enable  those  agencies  already 
existing  in  prisons,  such  as  self-government,  education,  industrial  training, 
•etc.,  to  be  used  more  effectively. 

CLEARING  HOUSE  AT  BEDFORD  HILLS 

All  that  has  been  said  relating  to  the  need  of  a  clearing  house  for  the 
sentenced  male  felons  of  New  York  State  may  be  restated  with  equal,  if 
not  greater  emphasis  in  regard  to  the  female  inmates  of  the  State  penal 
;and  corrctional  institutions. 

The  well  recognized  menace  that  venereal  disease  is  to  the  general 
public  and  the  high  frequency  of  those  conditions  as  are  found  among 
delinquent  women,  is  a  matter  for  serious  consideration.  In  440  cases 
studied  at  the  New  York  State  Reformatory  for  Women  at  Bedford  Hills, 
48  per  cent,  gave  positive  reactions  to  the  Wasserman  test  for  syphilis. 
Of  289  prostitutes  studied  by  the  Baltimore  Vice  Commission  63.7  per  cent, 
showed  syphilis.  At  the  Reformatory  for  Women  at  Framingham,  Mass., 
75.  per  cent,  of  the  population  were  suffering  from  gonorrhea.  At  the 
New  York  Reformatory  for  Women  at  Bedford  Hills  73  per  cent,  showed 
the  presence  of  gonorrhea. 

The  relationship  that  these  two  conditions  bear  to  feeble-mindedness 
need  not  be  enlarged  upon  here.  Venereal  disease  and  feeble-mindedness 
form  a  combination  as  productive  of  human  wretchedness  and  misery  as 
any  scourge  that  has  ever  afflicted  mankind.  Twenty-three  per  cent, 
of  the  women  at  the  Reformatory  at  Framingham,  Mass.,  who  were  fit 
subjects  for  permanent  segregation  on  account  of  mental  defect,  showed 
90  per  rent,  of  gonorrhea  and  60  per  cent,  of  syphilis. 

At  least  30  per  cent,  of  the  population  in  representative  penal  in¬ 
stitutions  for  women  in  New  York  State  are  feeble-minded,  as  indicated 
in  table  No.  IX.  No  satisfactory  figures  were  obtainable  showing  how 
large  a  number  of  the  women  prisoners  were  suffering  from  other  patho¬ 
logical,  nervous  and  mental  conditions,  such  as  mental  disease  or  deteriora¬ 
tion,  psychopathic  personality,  epilepsy  and  the  like.  However,  the  high 
percentage  of  feeble-mindedness  is  of  itself  causing  many  institution 
•officials  to  feel  as  stated  in  the  report  of  the  State  Hospital  Development 
Commission,  that  “the  really  reformable  type  is  becoming  in  certain  re¬ 
formatories  an  almost  unknown  quantity  and  the  defectives  already  so 
large  that  the  question  arises  whether  it  would  not  be  better  to  make 
one  or  two  of  these  institutions  actually  ‘defective  delinquent’  institutions 
and  continue  the  others  as  reformatories  with  a  population  that  is  really 
.Teformable.” 


17 


TABLE  No.  IX 


Showing  percentage  of  Feeble-minded  Women  Found  in  Certain  Penal 
and  Correctional  Institution s  in  New  York  State 


INSTITUTION 


N.  Y.  State  Reformatory 

(Bedford  Hills) _ Dr. 

State  Prison  for  Women 

(Auburn)  _ Dr. 

N.  Y.  County  Penitentiary.  Dr. 

N.  Y.  City  Workhouse _ Dr. 

Inwood  House  (N.Y.  City). Dr. 
Western  House  of  Refuge 
for  Women  (Albion 
N.  Y.) - Dr. 


Number  of  Percentage 
cases  examined  Feeble-minded 


335 


31.9 


AUTHORITY 


Mabel  Fernald _ 

Mabel  Fernald _ 

Mabel  Fernald _ 

Mabel  Fernald _ 

Mabel  Fernald _ 


Jessie  L.  Herrick. _ 


76 

25 

105 

26.6 

95 

42.7 

69 

15.1 

185 

33.5 

We  feel  that  the  establishment  of  a  clearing  house,  and  a  reception 
prison  at  the  New  York  State  Reformatory  for  Women  at  Bedford  Hills 
through  which  would  pass  all  sentenced  women  felons  and  those  of  lesser 
offenses  selected  by  the  Courts  of  the  State,  is  the  most  intelligent  solu¬ 
tion  of  the  serious  problem  now  presented  by  the  delinquent  women  in 
New  York  State.  The  Laboratory  of  Social  Hygiene  might  well  be  de¬ 
veloped  into  an  institution  for  this  purpose.  All  of  us  are  familiar  with 
the  serious  consequences  resulting  from  too  long  a  delay  in  receiving 
into  proper  institutions  feebleminded  girls  after  they  have  developed 
marked  delinquent  traits,  and  especially  is  this  true  during  the  child¬ 
bearing  age.  Such  a  clearing  house  would  function  for  those  institutions 
handling  the  women  prisoners  of  New  York  State  in  the  same  way  that 
the  clearing  house  at  Sing  Sing  would  function  for  men. 

It  is  further  suggested  that  in  order  to  make  effective  the  findings 
in  this  clearing  house,  a  proper  arrangement  of  the  various  other  insti¬ 
tutions  handling  women  prisoners  be  made.  In  this  connection  it  is  sug¬ 
gested  that  the  State  Prison  for  Women  at  Auburn  be  transferred  to  the 
State  Farm  for  Women  at  Valatie,  after  being  made  more  secure;  that  the 
Reformatory  for  Women  at  Bedford  Hills  be  made  the  State  Institution 
for  Female  Defective  Delinquents;  that  the  House  of  Refuge  for  Women 
at  Albion  be  used  only  for  those  who  are  found  capable  of  profiting  by 
the  training  afforded  and  capable  of  being  reconstructed  to  such  a  degree 
as  would  enable  their  restoration  to  the  community. 


CLEARING  HOUSES  FOR  THE  DEPARTMENT  OF  CORRECTION  OF 


NEW  YORK  CITY 


New  York  City,  because  of  its  extensive  population,  may  be  considered 
apart  from  the  rest  of  the  State,  but  all  the  facts  deduced  for  the  estab¬ 
lishment  of  clearing  houses  at  Sing  Sing  Prison  and  the  Reformatory  at 
Bedford  Hills  bear  with  equal  force  upon  the  needs  of  the  Department 
of  Correction  of  New  York  City. 

For  the  year  ending  June  30,  1917,  71,528  prisoners  were  received  in 
New  York  City  institutions.  A  large  army  of  physically  and  mentally 
handicapped  individuals  are  being  bandied  about  from  institution  to  in¬ 
stitution,  locked  up  and  turned  out  again  and  the  process  is  repeated 
over  and  over.  We  are  of  the  opinion  that  there  should  be  established 
on  Blackwell’s  Island  two  clearing  houses,  one  for  male  prisoners  and 
one  for  female  prisoners,  utilizing  the  old  penitentiary  for  men  and  the 
Workhouse  for  Women,  which  plan  is  now  under  way.  These  institu¬ 
tions  should  be  equipped  with  all  the  modern  facilities  suggested  for  the 
State  clearing  houses. 

Through  those  two  institutions  should  pass  all  the  prisoners  sentenced 
to  institutions  under  the  management  of  the  New  York  City  Department 


18 


of  Correction,  and  after  proper  study  and  treatment,  and  the  character  of 
prtyblem  which  each  individual  presents  has  been  carefully  outlined,  they 
should  be  distributed  to  each  of  the  City’s  correctional  institutions  in  the 
light  of  the  needs  of  each  case. 

It  will  be  obvious  that  owing  to  the  large  number  of  mental  defectives 
that  will  be  found  at  these  clearing  houses,  incapable  of  profiting  by  the 
ordinary  methods  provided  in  the  existing  machinery  of  the  Department 
of  Correction,  that  two  special  institutions,  one  for  male  defective  delin¬ 
quents  and  one  for  female  defective  delinquents  will  be  required. 

PAROLE  AND  “AFTER-CARE” 

The  object  after  all  in  this  more  intelligent  and  more  humane  atti¬ 
tude  towards  the  criminal  is  to  so  reconstruct  his  personality  that  he 
may  be  restored  as  promptly  and  as  permanently  as  possible  to  his  normal 
relation  to  society.  In  order  to  determine  how  far  the  Prison  Admini¬ 
stration  has  succeeded  in  this  object,  each  individual  prisoner  when  he 
becomes  eligible  for  parole  should  be  returned  to  the  reception  prison 
where  he  will  be  further  observed,  in  order  to  determine  how  well  this 
object  has  beeen  accomplished.  Much  light  on  his  fitness  for  parole  and 
on  the  measures  to  be  adopted  in  the  after-care  work  given  the  case  will 
be  obtained  through  the  knowledge  gathered  in  the  investigations  made 
at  the  clearing  house.  Too  much  emphasis  cannot  be  laid  on  this  phase 
of  the  prisoner’s  treatment.  Reformation  of  the  offender  is  never  fully 
accomplished  within  prison  walls.  At  best  such  an  environment  is  arti¬ 
ficial. 

The  unusual  success  obtained  in  after-care  work  with  the  insane  by 
certain  phychopathic  hospitals  where,  through  the  agency  of  a  social 
service  department  many  formerly  mentally  ill  patients  have  been  satis¬ 
factorily  adjusted  to  the  conditions  of  normal  living,  may  well  serve  as 
an  example  for  after-care  treatment  of  criminals,  in  connection  with  such 
clearing  houses  as  are  proposed.  The  period  following  the  release  of  the 
prisoner  is  a  critical  one  for  him  and  may  be  fraught  with  most  serious 
consequences  to  society. 

PREVENTION  THROUGH  COURT  CLINICS 

Prevention  is  better  than  cure.  Would  it  not  be  more  sensible,  more 
economical  and  more  humane  to  prevent  insanity,  pauperism,  prostitution, 
criminality  and  the  like  than  to  spend  vast  sums  in  undertaking  to  cure, 
or  when  this  was  impossible,  in  providing  ultimate  custodial  care? 

It  needs  no  argument  to  convince  the  average  thoughtful  person,  that 
from  the  vast  and  grim  procession  of  petty  offenders  passing  through  our 
lower  courts,  is  recruited  the  greater  portion  of  criminals  eventually 
‘found  in  the  prisons  of  this  country.  The  large  number  of  “repeaters” 
who  have  spent  a  greater  portion  of  their  lives  in  and  out  of  prison, 
whose  conduct  was  in  a  measure  due  to  serious  abnormal  conditions  from 
which  they  suffered,  such  as  mental  disease  or  deterioration,  feeble¬ 
mindedness,  etc.,  could  have  been  discovered  long  before  .they  were  sent  to 
prison,  at  a  time  when  deterioration  in  the  mentally  ill  and  serious  crimi¬ 
nal  tendencies  in  the  mentally  defective  would  have  been  more  or  less 
preventable.  The  State  cannot  afford  to  waste  human  material  in  such 
a  manner  or  knowingly  allow  human  material  to  cause  waste  to  other 
human  beings  in  the  community.  v 

Studies  have  already  been  made  calling  attention  to  the  frequency 
with  which  this  same  group  of  mentally  disabled  individuals  is  to  be  found 
in  the  courts.  In  a  study  made  in  1917  by  the  psychopathic  laboratory  of 
the  Police  Department  of  New  York  City,  of  502  selected  cases,  58  per 
cent,  suffered  from  some  nervous  or  mental  abnormality.  A  study  of 
female  offenders  by  Dr.  Clinton  P.  McCord  at  Albany  showed  56  per 
nent.  exhibiting  nervous  or  mental  abnormalities.  A  study  of  81  women 
examined  in  the  night  court  of  New  York  City  by  Dr.  Mabel  Fernald 


19 


showed  25.4  per  cent,  feeble-minded.  A  study  of  1,000  offenders  by  the 
Medical  Service  of  the  Municipal  Court  of  Boston  showed  23  per  cent, 
feeble-minded,  10.4  per  cent,  psychopathic,  3.17  per  cent,  epileptic  and  9 
per  cent,  mentally  diseased  and  deteriorated.  Of  the  1,000  cases  referred 
to,  456  or  45.6  per  cent,  exhibited  abnormal  mental  conditions.  Every 
one  of  these  456  persons  is  a  potential  and  probable  candidate  for  ulti¬ 
mate  custodial  treatment. 

We  believe  it  would  be  practical  economy  to  undertake  proper  ad¬ 
justment  of  such  individuals  at  a  time  When  their  condition  may  be  re¬ 
coverable,  or  serious  delinquent  tendencies  preventable,  rather  than  to  wait 
until  such  deterioration  has  taken  place  or  criminal  habits  have  become 
so  firmly  fixed  as  to  warrant  custodial  treatment. 

How  closely  the  problem  of  the  mentally  defective  and  diseased  delin¬ 
quent  affects  our  courts,  how  seriously  it  hampers  them  in  performing  their 
protective  function  is  impossible,  within  the  limited  space  available  in  this 
report  to  satisfactorily  discuss.  However,  a  limited  view  of  the  situation 
as  it  is  seen  in  the  average  lower  courts  may  be  obtained  from  the  follow¬ 
ing  table  showing  selected  groups  of  problem  cases  studied  by  the  Medical 
Service  of  the  Municipal  Court  of  Boston : 

TABLE  No.  X 

Showing  Relationship  of  Mental  Defect  and  Disease  to  Selected  Types 
of  Problem  Cases  in  Court.  ( 


DIAGNOSIS 

100  100  Immoral 

100  100  Drunken 

100 

Drug  Users 

Women 

Shoplifters 

Women 

Vagrant# 

Normal  _  _ _ _ 

18.5  p.  C. 

20  p.  C. 

22  p.  C. 

11  p.  C. 

2  p.  C. 

Dull  Normal  _  _ 

20 

32 

12 

21 

8 

Feebleminded  _ _ 

28.5 

30 

25 

32 

36 

Epileptic  _  _  _  _ 

1.5 

6 

10 

8 

2 

Alcoholic  deterioration — 

__  __ 

2 

_ _ 

7 

12 

Drug  deterioration  __  — 

14.4 

2 

__  — 

__  _ 

4 

Psychopaths 

14.3 

23 

10 

8 

Psychosis  _  _ 

2.8 

i  c 

8 

11 

28 

Total  exhibiting  ab¬ 
normal  mental 
conditions  _ 

61.5  p.  c. 

48  p.  c. 

66  p.  c. 

68  p.  c. 

90  p.  c. 

It  may  be  seen  from  fable  No.  X  that  among  the  problem  cases  passing 
through  our  lower  courts,  a  strikingly  large  number  of  abnormal  individ¬ 
uals  is  to  be  found ;  individuals  unfitted  to  profit  by  measures  intended 
for  normal  persons  and  as  a  consequence  return  to  the  court  over  and 
over  again  forming  the  very  nucleus  to  recidivism. 

There  is  no  question  more  closely  linked  up  with  the  fundamental  duty 
of  the  criminal  courts,  the  protection  of  society  from  anti-social  acts,  than 
the  proper  disposition  of  those  who  through  no  fault  of  their  own,  are  suf¬ 
fering  from  such  mental  handicaps,  and  who,  because  of  such  mental  con¬ 
ditions,  are  liable  to  become  a  burden  and  a  menace  to  the  community. 

This  fact  is  being  fully  appreciated  by  judges  throughout  the  country 
and  in  many  places  attempts  are  being  made  to  secure  proper  medical 
assistance.  In  two  cities,  Boston  and  Chicago,  special  medical  clinics  have 
been  already  officially  created  within  the  municipal  courts,  which  are  con- 
tributary  to  a  better  understanding  and  a  more  intelligent  treatment  of 
offenders  coming  before  these  courts. 

It  is  not  to  be  expected  that  such  medical  clinics  in  the  courts  can 
ever  take  the  place  of  clearing  houses  in  the  prisons ;  such  opportunities 
for  prolonged  observation  and  investigation  into  the  causitive  factors  un¬ 
derlying  careers,  not  to  mention  the  advantages  afforded  from  intensive 
vocational  training  and  physical  and  mental  rehabilitation  of  the  prisoner, 

20 


cannot  be  secured  in  the  short  time  allowed  by  the  study  of  a  case  in  the 
lower  courts.  What  these  clinics  can  do,  and  most  effectively  do,  is  to 
act  as  a  net  or  sieve  for  the  court,  to  determine  beforehand  those  who, 
because  of  constitutional  defects  and  mental  handicaps,  are  less  likely  to 
profit  by  the  routine  measures  employed  by  the  court  in  dealing  with 
delinquents,  and  who,  because  of  such  pathological  conditions,  carry  the. 
potentialities  for  delinquent  careers.  Through  the  use  of  such  clinics  no 
longer  will  feeble-minded  and  mentally  diseased  and  deteriorated  persons 
be  tried  out  again  and  again  on  probation  and  after  that  has  failed,  sen¬ 
tenced  for  short  periods  of  confinement  in  jails,  lockups  and  houses  of 
correction,  losing  thereby  whatever  opportunities  there  might  have  been 
for  restoring  to  health  the  mentally  sick  and  preventing  character  deter¬ 
ioration  and  criminal  tendencies  in  the  mentally  defective. 

Such  clinics  will  be  as  ^a  ray  of  sunshine  in  the  gloom  which  sur¬ 
rounds  the  lives  of  the  criminal  insane,  for  years  before  such  mental  ship¬ 
wrecks  have  taken  place.  The  early  manifestations  of  their  condition 
will  have  been  noted  on  the  appearance  of  these  individuals  as  petty  of¬ 
fenders  in  the  lower  courts,  and  through  the  agency  of  such  clinics,  meas¬ 
ures  will  be  set  in  motion  towards  restoring  them  to  normal  health. 

Through  the  establishment  of  -  such  clinics,  the  feeble-minded — the 
“mental  children” — passing  through  adult  courts  whose  so-called  crimes 
have  been  more  the  consequence  of  neglect  and  ignorance  on  the  part  of 
the  community  than  any  innate  wickedness  on  their  part,  will  be  dealt 
with  squarely  on  the  basis  of  their  needs  as  well  as  their  deeds. 

But  this  is  only  a  part  of  the  helpful  service  furnished  by  such  medi¬ 
cal  clinics  within  the  courts.  The  large  percentage  of  criminals  suffer¬ 
ing  from  physical  disabilities  is  attested  by  reports  coming  from  penal 
institutions  throughout  the  country.  During  the  administration  of  Dr. 
Katharine  B.  Davis,  arrangements  were  made  for  the  same  physical  ex¬ 
amination  as  that  required  for  admission  to  the  United  States  army  of 
all  inmates  of  New  York  city  correctional  institutions.  The  Reformatory 
for  Male  Misdemeanants  of  New  York  City  where  the  inmates  average 
barely  20  years  of  age,  only  8  per  cent,  passes  the  required  physical  exam¬ 
ination.  In  the  penitentiary  where  the  average  age  is  greater,  only  5  per 
cent,  passed  the  required  examination.  In  the  workhouse  where  those 
who  are  “down  and  out”  are  to  be  found  in  large  numbers,  only  1  per 
cent,  passed  the  required  examination. 

All  studies  that  have  been  made  of  offenders  passing  through  the 
lower  courts  show  a  startling  number  of  individuals  suffering  from  acute 
and  chronic  physical  disease  such  as  tuberculosis,  Bright’s  disease,  asth¬ 
ma.  heart  disease,  syphilis  and  gonorrhea.  The  vital  importance  of  the 
early  recognition  of  these  conditions  cannot  be  overestimated.  Their  re¬ 
lationship  to  an  individual’s  industrial  efficiency  and  through  this  to  his 
delinquency,  may  be  seen  from  the  following  study  made  by  Dr.  Anderson : 

A  group  of  1,000  delinquents  was  studied  with  the  purpose  in  view 
of  determining  what  part,  if  any,  routine  physical  examinations  might 
play  in  the  disposition  of  a  delinquent’s  case  in  court  and  later  in  the 
institutions  of  reconstructive  measures  while  on  probation.  It  was  found 
that  85  per  cent,  of  those  in  good  or  fair  physical  condition  had  been  and 
were  still  self-supporting,  while  only  18  per  cent,  of  those  found  to  be  in 
poor  or  bad  physical  condition  had  been  and  were  still  self-supporting. 

That  96  per  cent,  of  those  regularly  employed  were  found  in  good  or 
fair  physical  condition,  while  only  4  per  cent,  were  found  to  be  in  poor 
or  bad  physical  condition. 

That  86.3  per  cent,  of  those  who  were  rated  as  “never  worked”  were 
found  to  be  in  poor  or  bad  physical  condition.  The  chances  of  being  self- 
supporting  were  more  than  four  to  one  in  favor  of  the  individual  in  good 
physical  condition. 

Further,  47  per  cent,  of  these  individuals,  practically  every  other 
person  was  suffering  from  syphilis  or  gonorrhea.  Only  positive  laboratory 
findings  were  included. 


21 


Certainly  something  more  than  intelligent  advice,  short  terms  of  con¬ 
finement  in  prison,  general  supervision  in  the  community  and  securing 
employment,  is  needed  to  solve  the  problem  presented  by  the  delinquent 
whose  physical  endurance  is  rapidly  diminishing  under  a  progressive 
Bright’s  disease,  or  the  delinquent  who  is  scattering  syphilis  and  gonorr¬ 
hea  broadcast  into  the  community.  These  may  be  conditions  of  more 
vital  importance  to  his  future  welfare  and  the  community  in  which  he 
lives  than  any  other  consideration. 

The  help  such  medical  clinic  will  be  to  the  court  in  determining  th* 
presence  of  such  conditions  land  securing  the  proper  protection  to  the 
community  and  treatment  of  the  individual  is  obvious. 

It  is  not  necessary  in  such  a  program  to  emphasize  the  part  played  in 
the  prevention  of  delinquency  by  the  juvenile  court.  Dr.  William  Healy, 
Director  of  the  Judge  Baker  Foundation  of  Boston,  has  well  said : 

“The  determinants  of  delinquent  careers  are  the  conditions  of  youth. 
Observers  in  many  quarters  are  united  in  stating  that  almost  all  recid¬ 
ivists,  confirmed  criminals,  show  plainly  their  tendencies  at  least  by  late 
childhood.  The  factors  then  that  turn  the  individual  toward  misbehavior 
are  those  already  present  in  childhood.” 

This  very  fact  and  the  presence  of  feeble-mindedness  and  other  nervous 
and  mental  abnormalities  among  delinquent  children,  and  the  splendid  work 
done  in  connection  with  juvenile  courts  by  Dr.  Healy  in  Boston,  Dr.  Helen 
Montague  in  New  York  City,  and  others,  have  convinced  those  who  have 
given  serious  consideration  to  this  phase  of  the  subject,  that  the  financial 
saving  in  the  prevention  of  delinquent  careers,  resulting  from  such  studies 
and  reconstructive  work  as  have  been  done  through  already  established 
clinics  more  than  justify  the  financial  outlay  for  their  maintenance,  to  say 
nothing  of  its  humanitarian  aspect. 

So  important  are  those  beginnings  of  delinquent  careers  as  found  in 
childhood  in  their  relation  to  the  whole  question  of  criminality,  that  a 
thoroughgoing  study  of  each  delinquent  child  brought  into  court  is  an 
ideal  which  the  State  can  most  profitably  set  itself  to  attain. 

The  establishment  throughout  the  State  of  mental  clinics  to  accomplish 
such  aims  will  prove  to  be  an  investment  paying  back  in  dollars  and  cents 
saved  from  the  expense  of  courts,  prisons,  reformatories  and  almhouses; 
an  investment  not  only  inthe  prevention  of  crime  and  poverty,  but  in  the 
joy  and  happiness  coming  from  well  adjusted  human  lives.  (Such  clinics 
functioning  not  only  for  the  courts,  but  for  the  schools  and  the  entire  com¬ 
munity,  will  be  a  center  from  which  radiate  influences  tending  to  prevent 
much  of  the  social,  mental  and  moral  wrecks  of  the  coming  generations. 

Undoubtedly  from  existing  knowledge  as  to  the  development  of  per¬ 
sonality  traits  and  mental  characteristics  it  will  be  possible,  through  the 
study  of  the  peculiar,  retarded,  abnormal  and  subnormal  children  in  the 
schools  and  in  the  community  to  set  in  motion  measures  for  the  develop¬ 
ment  of  desirable  character  traits  and  in  the  inhibition  of  undesirable 
ones ;  and  to  select  very  early  in  their  careers  those  children  in  need  of 
very  specialized  treatment. 

It  is  evident  in  the  larger  cities,  particularly  in  New  York  city,  owing 
to  the  great  number  of  delinquents  passing  not  only  through  the  adult 
courts  but  the  juvenile  courts,  that  special  clinics  attached  to  those  courts 
will  be  necessary. 

We  note  with  approval  that  a  comprehensive  plan  for  mental  clinics 
is  being  worked  up  into  a  state  wide  program  by  the  New  York  State 
Commission  for  the  Feeble-Minded.  Through  utilizing  the  Lockwood  Law, 
the  abnormal  and  backward  child  in  school  will  be  carefully  studied  and 
suitable  measures  applied  for  his  re-adjustment  before  he  has  become  a 
delinquent  child  or  an  industrial  failure. 

The  various  clinics  throughout  the  State  should  be  supervised  and 
their  activities  directed,  as  the  State  Commission  for  the  Feeble-Minded, 
plans,  by  a  state  board  to  govern  all  such  clinics.  An  important  part  of 


22 


\ 


this  whole  program  for  the  prevention  of  delinquency  would  be  undertaken 
by  the  establishment  of  a  psychopathic  hospital  in  New  York  City  as  has 
been  proposed  by  the  State  Hospital  Development  Commission.  Such  an 
institution  would  serve  to  prevent  many  individuals  from  becoming  perma¬ 
nently  disabled  by  mental  disease,  and  throughout  the  community  serve 
as  a  stimulus  for  better  mental  hygiene.  It  also  would  be  of  practical 
service  in  the  prevention  of  delinquency,  in  that  many  individuals  who 
would  otherwise  become  serious  problems  for  the  courts  and  penal  insti¬ 
tutions  of  the  state,  would  through  the  activities  of  such  an  institution  be 
enabled  to  adjust  themselves  to  the  conditions  of  normal  living. 

In  conclusion  the  Committee  desires  to  express  its  appreciation  to 
Dr.  Anderson  for  his  very  valuable  assistance  in  the  investigation  and  in 
the  preparation  of  this  report,  and  to  the  National  Committee  for  Mental 
Hygiene  for  its  co-operation  and  advice. 

RECOMMENDATIONS 

First:  That  all  males  convicted  of  felony  and  noit  released  under 
suspension  of  imposition  or  execution  of  sentence  pass  through  the  pro¬ 
posed  clearing  house  at  Sing  Sing  Prison,  and  thence  be  distributed  to  each 
of  the  state  prisons  and  the  New  York  State  Reformatory  at  Elmira  in  the 
light  of  the  needs  of  each  case. 

Second :  That  all  sentenced  female  felons  and  those  convicted  of 
offenses  of  a  lesser  degree  than  felony  selected  by  the  court,  pass  through 
a  clearing  house  to  be  established  by  the  State  at  the  New  York  State 
Reformatory  for  Women  at  Bedford  Hills,  and  from  this  clearing  house, 
after  a  period  of  study  and  reconstruction,  be  distributed  to  other  state 
institutions  for  women  in  the  light  of  the  needs  of  each  case. 

Third :  The  prompt  establishment  of  the  proposed  clearing  houses 
on  Blackwell’s  Island  to  function  for  the  Department  of  Correction  of 
New  York  City  in  the  same  way  as  the  Sing  Sing  and  Bedford  Hills  clear¬ 
ing  houses  function  for  the  state  institutions,  coverting  the  peniten¬ 
tiary  into  a  clearing  house  for  men  and  the  workhouse  into  a  clearing  house 
for  women. 

Fourth:  The  establishment  of  a  state  institution  for  the  care  and 
treatment  of  male  defective  delinquents,  providing  for  their  commitment, 
release  and  transfer.  The  Eastern  New  York  Reformatory  at  Napanoch 
is  suggested. 

Fifth:  The  establishment  of  a  state  institution  for  the  care  and 
treatment  of  female  defective  delinquents,  providing  for  their  commit¬ 
ment,  release  and  transfer.  The  New  Y6rk  State  Reformatory  for  Women 
at  Bedford  Hills  is  suggested. 

Sixth :  The  establishment  of  an  institution  in  connection  with  the 
Department  of  Correction  of  the  city  of  New  York  for  the  care  and  treat¬ 
ment  of  male  defective  delinquents. 

Seventh :  The  establishment  of  an  institution  in  connection  with  the 
Department  of  Correction  of  the  city  of  New  York  for  the  care  and  treat¬ 
ment  of  female  defective  delinquents. 

Eighth:  That  all  children  brought  before  the  court,  charged  with  de¬ 
linquency  or  improper  guardianship,  be  examined  mentally,  the  examinations 
to  be  made  either  in  a.  clinic  attached  to  the  court,  or  in  a  central  clinic 
to  be  provided,  and  those  found  feeble-minded  to  be  committed  tw>  proper 
institutions  if  in  need  of  institutional  care. 

Ninth:  That  all  adults  convicted  of  offenses  less  than  felony  *und  all 
adults  convicted  of  felony  and  released  under  suspension  of  imposition  or 
execution  of  sentence,  be  examined  mentally  in  the  discretion  of  the  judge 
at  a  clinic  attached  to  the  court  or  at  a  central  clinic. 


23 


Tenth  .  The  establishment  of  mental  clinics  throughout  the  State  a* 
p  anned  by  the  State  Commission  for  the  Feeble-Minded,  and  the  establish 
ment  of  a  psychopathic  hospital  in  New  York  City  as  proposed  by  the 
State  Hospital  Development  Commission. 


Eleventtt :  The  creation  of  a  state  board  to  supervise  and  direct  the 
activities  of  these  mental  clinics,  thereby  securing  proper  standardization 
in  the  way  of  methods  used  and  results  obtained. 

Twelfth :  That  the  Legislature  be  requested  to  enact  such  legislation 
as  will  put  these  recommendations  into  effect. 


Respectfully  submitted. 

FRANK  E.  WADE 
JOHN  S.  KENNEDY, 

SARAH  L.  DAVENPORT, 
GEORGE  W.  DAVIDS, 

ALLAN  I.  HOLLOWAY. 

Commissioners. 


Albany,  N.  Y.  December  3,  1918. 


